OR Allocations for Post-COVID Ramp Up

As the COVID-19 pandemic became widespread, health systems such as Michigan Medicine needed to reallocate space and resources to care for COVID-19 patients. Due to both this redistribution of efforts and to government mandates on freezing all but essential services, the majority of planned surgical cases (all but those deemed urgent or emergent) needed to be postponed.

As the demand for COVID-19 care decreases, health systems can begin redistributing their resources back towards “normal” operations. This “ramp-up” presents a unique set of challenges to decision-makers who must determine how many operating rooms to re-open, in what locations, on what days of the week, and for how many hours, as well as determining which clinical services to allocate these ORs to. They must consider the competing needs of three patient populations (those whose surgical cases were postponed due to COVID-19, those new patients who are now entering the system, and new COVID-19 patients). They must consider potential bottleneck constraints associated with all of their resources due to the pandemic (PPE, staffing, testing supplies, etc.). And finally, they must remain flexible and be prepared for the possibility of a new surge in COVID-19 patients which would require the system to ramp back down its normal operations.

The tools below were designed to support health system decision-makers as they allocate capacity and gradually ramp-up surgical activity. 

OR Allocation Planning Tool (Aggregated Case Volume) – Click Here to Download
The purpose of this Excel-based tool is to provide hospitals with the ability to conduct “what-if” analyses to evaluate different allocations of their operating rooms and resources across different clinical services. To set up the tool, the user provides input on their availability of physical resources such as PPE and COVID tests as well as time/space resources like ICU bed days. In addition, they provide aggregate data on the volume of backlogged patients in each service and the surgical urgency of these patients. To conduct analyses, the user then specifies how much OR time to open at each surgical location and allocates this OR time to specific services, and the tool automatically calculates the utilization of each resource (highlighting those that are near or exceeding capacity) and the impact on patient backlog.

OR Allocation Planning Tool (Individual Cases) – Click Here to Download
The Individual Cases version of the tool is similar to the Aggregated Case Volume version, but allows the user to provide more in-depth analysis about the backlog of cases. Specifically, the user provides a list of all backlogged cases, and can assign each case a specific urgency score. The priority of a surgery can then be determined through a user-defined range of urgency scores.

User Manual – Click Here to Download
This document details how to use both tools above. 

To provide feedback on the above tools, please click here.